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Indolent Corneal Ulcers in Dogs

Thursday, March 01, 2012

DJ Haeussler, Jr., BS, MS, DVM
Practice limited to Ophthalmology
Garden State Veterinary Specialists

The cornea is the clear window that is in the front of your eye. This is where humans place their contact lenses. When a scratch or a defect occurs in the cornea, this is called an ulcer. What is an indolent corneal ulcer in a dog? Indolent corneal ulcers are typically non-healing superficial corneal ulcers of dogs otherwise known as superficial corneal epithelial defects (SCCEDs). These are also known as canine recurrent erosion, Boxer ulcers, non-healing erosions, and recurrent epithelial erosions, amongst others. These ulcers are commonly seen in the Boxer breed as well as older dogs and dogs that have current corneal disease or eyelid diseases. These ulcers can take weeks or even months to heal and are very painful. When ulcers take a long time to heal, corneal vessels will form which causes redness to the cornea and can lead to chronic pain and blindness. Indolent ulcers are superficial meaning that they occur in the outermost portion of the cornea. Unfortunately, this is also where the majority of the sensory nerves of the cornea are located, which causes pain for your loved one.

Indolent ulcers should be considered in superficial ulcers that fail to heal appropriately. Appropriate time for a corneal ulcer to heal is less than two weeks. Indolent ulcers typically occur in any middle-aged dog with an erosion that fails to heal within 2 weeks. These typically happen in dogs 8-9 years old, however it can happen in any age, breed, or sex. Other potential causes of delayed wound healing include eyelid abnormalities, foreign bodies, tear film abnormalities, exposure, eyelid paralysis, and others.

Indolent ulcers typically have a classic clinical appearance. They are superficial ulcers with a loose ring of epithelium. The epithelium is the outermost layer of cells of the cornea. The fluorescein stain will work its way under the loose epithelium. Indolent ulcers do not have loss of stroma, only epithelium. Stroma is the thick part of the cornea that helps the cornea to maintain its shape.

The degree of pain in these patients is typically varied. Some patients are extremely painful, whereas chronic cases are typically less painful. Pain is evidenced in the dog by squinting, tearing, and redness to the white area on the eye.

Past treatments involve topical antibiotics as well as a grid keratotomy, which utilizes a needle to “scratch” the cornea. This allows the epithelial cells to migrate into the scratches and adhere to the cornea for better healing. This is the equivalent of how the construction workers scratch the pavement in the summer before laying down blacktop. At Garden State Veterinary Specialists, we use a combination of cotton-tipped applicator debridement which removes the dead epithelium from the cornea, then apply topical antibiotics, pain medications, a contact lens, and newer technology…a diamond burr keratotomy. This technology not only keeps the patient’s eye safer during the procedure, but heals the cornea much more quickly (usually less than 2 weeks!). It is important to be aware of this condition if you own a dog over the age of 7 years old or if you own a Boxer of any age or sex. Should you notice any squinting, tearing, or redness to your dog’s eye(s), you should seek a medical examination from your family veterinarian. If warranted, your veterinarian may refer you to Garden State Veterinary Specialists for treatment!

This article is for informational purposes only and should not be used as a substitute for the professional advice of your veterinarian.

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